抑郁症患者低频振幅与艾司西酞普兰疗效的关联性研究

Correlation between amplitude of low-frequency fluctuations and treatment response to escitalopram in patients with major depressive disorder

目的运用低频振幅(ALFF)探讨抑郁症患者局部大脑活动与艾司西酞普兰治疗反应的关系。方法选取30例不伴有精神病性症状的抑郁症患者,在基线采集受试静息态功能磁共振数据,并采用抑郁症状快速自评量表(QIDS-SR16)评估抑郁严重程度,所有受试接受8周的艾司西酞普兰治疗,根据治疗8周后QIDS-SR16减分率是否大于50%,将患者分为有效组及无效组,比较两组间ALFF差异。结果有效组治疗后第8周末QIDS-SR16总分低于无效组(P<0.05),减分率高于无效组(P<0.05)。有效组右侧纹状体以及右颞上回/右海马的ALFF值高于无效组(P<0.05)。右侧纹状体和右颞上回/右海马的ALFF值均与QIDS-SR16减分率呈正相关(P<0.05),受试者工作特性曲线分析提示其对疗效分类的特异度较高。结论基线右侧纹状体和右颞上回/右海马低活动可能是艾司西酞普兰治疗无效的标志性特征。

Objective To explore relationships between local brain activity and treatment response to escitalopram in patients with major depressive disorder(MDD)through the amplitude of low-frequency fluctuations(ALFF).Methods A total of 30 nonpsychotic patients with MDD were selected and conducted with resting-state functional magnetic resonance imaging scans at baseline.They were assessed with 16-Item Quick Inventory of Depressive Symptomatology,Self-Report(QIDS-SR16)and treated with escitalopram for 8 weeks.According to the reduction rates of QIDS-SR16 at the end of the 8th week,patients were divided into treatment responsive depression group(reduction rate>50%)and non-responding depression group(reduction rate≤50%),and ALFF differences between two groups were compared.Results At the end of the 8th week after treatment,the total score of QIDS-SR16 in treatment responsive depression group was significantly lower than that in non-responding depression group(P<0.05);and the reduction rate of QIDS-SR16 was significantly higher than that in non-responding depression group(P<0.05).The treatment responsive depression group showed higher ALFF values in right striatum,right superior temporal gyrus/right hippocampus than non-responding depression group(P<0.05).The ALFF values of right striatum,right superior temporal gyrus/right hippocampus were positively correlated with the reduction rate of QIDS-SR16(P<0.05).Receiver operating characteristic curve analysis suggested that both ALFF values of right striatum and right superior temporal gyrus/right hippocampus showed high specificity in classification of treatment response.Conclusion The low activities of right striatum,right superior temporal gyrus and right hippocampus at baseline may be the biomarkers of ineffective treatment of escitalopram.